Opioids and Gut Issues

Written by: Kevin Cann

An opioid is a chemical messenger that bonds to an opioid receptor. A well known group of opioids are known as our endorphins. These are the “feel good” neurotransmitters that come in after a workout. They are also associated with our ability to manage pain. In fact, pain medications work on our opioid receptors to decrease the sensation of pain and increase our tolerance to it. Opioid receptors are found in the brain, spinal cord, and gastrointestinal tract.

Opioid receptors being in the gut tells us that they play a role in gut function. One of the biggest side effects of opioid analgesics (fancy way of saying pain meds) is constipation. These pain meds, which act upon our opioid receptors, cause a disruption to peristalsis (our stomach contractions that allow us to digest food) and also blocks fluid secretion (Holzer, 2007). Modern medicine is attempting to find ways to enact upon the opioid system to manage pain, but not to interfere with the gut.

Low-dose naltrexone has shown promise in preclinical studies. Low-dose naltrexone has the ability to block excitatory opioid receptors without affecting inhibitory opioid receptors. In one study 42 patients were given .5mg of LDN for 4 weeks. The mean weekly number of pain free days increased with no adverse reactions (Kariv, 2006). There are two opioid receptors that play a role in gastrointestinal motility, delta and mu. The opioid receptor mu directly affects the myenteric plexus. The myenteric plexus is a part of the enteric nervous system that controls the activities of the digestive tract. Therefore, anything that enacts upon these receptors has the ability to cause constipation (Herndon, 2002).

A study done on mice showed that during intestinal inflammation there was an increase in the amount of active mu opioid receptors (Puig, 1998). Over time opioid tolerance can become an issue. This is when pain medications need to be increased in dosage or substituted for other medications.

The question I would like to ask is if we are under chronic inflammation and our opioid receptors are increasing in number; will this lead to an increase in desiring foods that will react upon our opioids such as sugar, or other opioid stimulating activities? Ever know that person that is addicted to running? Endurance athletics is known to increase intestinal permeability (Buckley, 2009). Was the intestinal permeability present before that led them to a behavior that would increase production of opioids and then it became cyclical with one affecting the other? Think about that same person’s diet; are they in love with their carbohydrates? Also, opiate addicts will eat the same amount of calories as non-addicts, but will choose foods high in sucrose and low in nutrients (Morabia, 1989). Is intestinal permeability a culprit of food cravings?

Gluten and casein have the abilities to create morphine like compounds. Are the people under chronic inflammation the ones who become addicted to these foods? Is that the person that you know that is in love with their cheese or their bread? Hippocrates had it right, “All disease begins in the gut.” There has to be a reason that our brain and gut communicate via the thickest nerve in our body and share receptors for the same neurotransmitters. The gut also contains the enteric nervous system which can work on its own without help from the brain.

This is where other diets fail. Other diets fail to look at health and weight loss from the inside out. They are mostly focused on what goes in from the outside. How can we make proper food choices without understanding how that food reacts in our body? We have enough inflammation caused from poor sleep, low vitamin D levels, stress from jobs, family, money, stimulants, and others that we do not need to be increasing inflammation anymore. This is where “Everything in moderation” does not work. Health and weight loss are not a simple math problem, but instead a series of complex chemical reactions that we have yet to fully understand. In the meantime, sleep well, take some deep breaths, get some sun, and eat adequate veggies to feed the gut the nutrients it needs to flourish, high quality protein sources for amino acids our neurotransmitter precursors, and healthy oils for brain healthy fats (animal meats contain some brain healthy fats as well).

Kevin Cann

Kevin is the Director of Strength and Conditioning at Total Performance Sports in Boston, MA. Kevin holds a master’s degree in Kinesiology and a bachelor’s degree in health and wellness with an emphasis in nutrition. He is a certified performance enhancement specialist through NASM. He is currently a student of former Team Russia Powerlifting Coach Boris Sheiko. He works with people of all walks of life from rehab, to weight loss, and to competitive athletes. Check out his site at www.totalperformancesports.com

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Comments

My husband is 54. When he was a very young man in the Army, he took part in the attempted rescue of American hostages in Iran, the attempt that ended in burning helo’s in the desert. He was burned very badly and was given a 6X overdose on morphine over the course of about 6 hours. Essentially, a very few medics were working on far too many men and weren’t properly marking who had gotten doses when. He was kept on morphine for the first few weeks of his burn treatment as well.
I’m pretty well convinced at this point that all of that morphine messed up his brain and gut chemistry. He’s mostly off gluten now, after six months of work, but he is literally addicted to sugar. He says it helps him control the desire for morphine, 30 plus years later. Any ideas on how to get him off sugar, heal his gut, and heal his brain?

Sorry to hear that, I am glad he is alive! I am not sure where in the country you live, but finding a practitioner that deals with neurotransmitter issues would be my first step. In San Fransisco there is a place called Recovery Systems and it is run by Julia Ross. They have amazing results dealing with these issues. Her site is http://www.moodcure.com. She has some good books and for more understanding of the issues check out Kenneth Blum’s research on Reward Deficiency Syndrome. It just comes down to recognizing imbalances biochemically and correcting them.

Hi, Yes..sugar is very addicting..may fill of the receptor sites instead of Morphine which may lower the immune system and turn into fat and clog blood vessels. Sugar may make the liver fatty. Lecithin may defat the liver. Fish oil may help the immune system. 100% no gluten/hidden gluten may help. LDN may help block hidden gluten. I need no gluten/dairy/soy/sugar/GMO…take vitamins/good oils/minerals/probiotic….LDN..detox. Lavender someone said may help burns. Vit E may help scars. Serrapeptase may eat up scars. Organic sulfur may lower swelling and detox sugar. Oregon grape root may lower blood sugar so it doesn’t hurt as much. Chromium/Mg may help a person use sugar. LDN may help a person heal and then maybe they will not need morphine. It blocks Morphine from working, but also heal and person so maybe they will not need the Morphine any more. Best wishes.

Sunlight (helps the immune system and helps to heal the gut lining),exercise, organic food, good water..not tap water, cooking by scratch pure food….. no food in a box/bag/premade/label/restaurant which may help avoid hidden gluten. Certified gluten free food may have 20ppm of gluten…too much. Nuts not sold in the shell/meat basting/some spices may have hidden gluten and lotion/make up etc. One restaurant cooks special for me…rice/veg/tea/extra mushrooms (no meat since the woks may have MSG/gluten in them).

EDTA/DMPS IV chelations from an Alternative doctor, 600mg of cilantro, zeolites, organic sulfur, Now brand- Detox support, Far Infrared Sauna and more may help detox. Hair tests show good minerals and heavy metals. Heavy metals can block thyroid and other chemical reactions in the body/brain.

LDN may help block hidden gluten/heal the gut lining and help the immune system, but the Celiac diet is still needed. 100% no gluten..no hidden or microscopic gluten may help. Cutting back on gluten or cheating by eating gluten hurts the immune system. It may take 1 1/2 months to heal the gut lining after getting hidden gluten.

Amour thyroid has some T3 and Calcitonin. Synthroid is only T4..may not convert to T3. Zn/Se/enough iron/strong probiotic may help convert T4 to T3 for thyroid.

Alternative doctors/chiropractors/acupuncturists and more may help with health/vitamins etc.

LDN may block hidden gluten, but may not be a strong enough of dose to block all gluten so a person needs to try to be 100% gluten free. LDN 3-4.5mg…taken at night may cause constipation and drinking more water may help, but that may be the only issue. It gives energy as it blocks the opioid receptor sites and prevents them from going down when gluten is eaten.. Taking it before bed may help tremendously more than taking it in the morning, but both may help. LDN is from a compounding pharmacy/Alternative doctor usually and is about $1 a day. LDN is like a miracle, but is a low dose so a person still needs the Celiac diet. LDN may help heal the gut lining/help the liver detox/help vision/help adrenals/help personality and every cell in the brain/body like a miracle for 18 hours. LDN may help Celiac health issues… Diabetes/cancer/ADD/losing hair/depression/low thyroid/fibromylagia and much more. Eating no gluten/dairy/soy/sugar/GMO…taking vitamins/good oils/minerals/probiotic…LDN..detoxing may help many brain/body health issues.
Best wishes.

Constipation may be helped by thyroid medicine, Mg citrate, Chia, pumpkin pie, carrots, Brown rice, more fiber, more exercise, more good water..not tap water with Cl/F, Raw walnuts (open the shell to avoid hidden gluten and freeze so fresh)..then drink lemon water which may squirt out bile and cause contractions in the intestines. Some people eat prunes for constipation. Painkillers may make the immune system go down and then a person may not heal as fsat. Relistor says bromide in it. Bromine may block thyroid and cause more constipation maybe. LDN may cause constipation. Try an Alternative doctor who may offer suggestsions. Psyllium, banana, teas and more may help constipation. LDN blocks the opioid receptor sites..would block painkillers. Acupuncturists/coenzymated B vitamins/Celiac diet..no gluten/dairy/soy/sugar/GMO…vitamins/good oils/minerals/probiotic/detoxing/LDN/detoxing may help pain. Chjiropractors/Prolotherapy and more may help pain. Best wishes.

Do any of you people understand how hard it is to manage all of this information, chronic pain, life and a “normal family?” I have been diagnosed with Interstitial Cystitis for over twenty years. Looking back, I’ve had it my entire life but it was livable. Now, I have two kids, one of whom I literally died having but was brought back from a DIC, or massive blood loss,clotting trauma and put in a medically induced coma for several weeks.
I have since been diagnosed with Chronic Fatigue Syndrome, Pelvic Floor Dysfunction (from the pain of the IC) and Fybromyalgia. All of these conditions are said to be “inflammatory conditions” and I agree. I also agree that opiates have probably played a role, along with other factors, in my weight gain, constipation, lethargy and depression. At one point, I was working out, albeit in my twenties and I looked very good on the outside, had strengthened my core with Pilates and Yoga was doing Spin classes in my second trimester but in all honesty, I still hurt. I was still in a ton of pain, depressed and insecure.
Now I am forty. I NEED TO EXERCISE but I’m a bit clueless as to where to start with that and my diet. I end up starving my body because I’m so confused about WHAT to eat and when! That has to be contributing to my feelings. My stomach feels full and fat and clogged from every direction to the point of embarrassment. I’m not lazy. I wake up at five thirty, take my meds, drink a few sips of coffee and proceed to get my five year old a seven year old, the latter of who has severe ADHD and Sensory Processing Disorder ready for their day. Simply getting a child with one of these conditions to eat and brush their teeth is like wrestling a baby piglet in a vat of oil!!
Sometimes things go well, lots of times, they do not but life goes on and they go to school. I almost always have some kind of a doctor or counseling appointment or shopping and my kids need to be picked up. Blah blah…
Where can I get real help from people with a serious knowledge base to help me start moving in the right direction bc my trained is trapped in the station and I’m starting to rust so badly that I’m afraid I won’t be able to come back.
I live in the Austin TX area

ROBB WOLF, author of The Paleo Solution, is a former research biochemist and one of the world’s leading experts in Paleolithic nutrition. Wolf has transformed the lives of tens of thousands of people around the world via his top ranked iTunes podcast and wildly popular seminar series.